Customer Satisfaction Survey
Thank you for allowing us to provide you pharmacy services. Please take a few minutes to give us your feedback on your experience. We value your comments and welcome any suggestions you may have to improve our services.
Name (optional)
Date
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type a question
*
Rows
Very Satisfied
Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Dissatisfied
N/A
Overall satisfaction with V-Care Pharmacy
Meeting your service expectation
Timeliness of the delivery of your order
Accuracy of your order
Helpfullness of the information you received about your medication(s)
Ability to reach the staff by phone who could answer your questions
Explanation of your insurance benefits
Explanation on how you can refill your medication(s)
Explanation on whom to call if there is an issue with your order
How can we improve our service?
Additional Comments?
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